无创粪便SDC2甲基化联合血清CEA在结直肠癌早期诊断中的应用价值

Application of noninvasive feces SDC2 methylation combined with serum CEA in the early diagnosis of colorectal cancer and the value assessment

目的:探究无创粪便SDC2甲基化联合血清CEA在结直肠癌早期诊断中价值。方法:选取64例结肠癌患者、58例结直肠瘤患者及60例健康对照组作为研究对象。提取粪便DNA,采用甲基化特异性PCR方法测定三组患者粪便基因SDC2甲基化情况,同时抽取静脉血应用化学发光免疫分析检测血清CEA含量。比较粪便SDC2甲基化联合血清CEA对结直肠癌的诊断效能。结果:结直肠癌组、结直肠瘤组和健康对照组患者SDC2检测的阳性率分别为67.19%、55.19%和11.67%;CEA检测的阳性率为39.06%、17.24%和8.33%;联合检测的阳性率则分别是82.81%、58.62%和13.33%,差异均有统计学意义(P<0.05)。ROC曲线分析发现,SDC2基因检测诊断结直肠癌AUC为0.629(95%CI:0.474~0.783),血清CEA水平诊断结直肠癌AUC为0.512(95%CI:0.357~0.632),联合检测诊断结直肠癌AUC是0.782(95%CI:0.642~0.856)。联合诊断结直肠癌的AUC值最高,与单独SDC2、CEA检测比较,差异有统计学意义(P<0.05)。结论:无创粪便SDC2基因甲基化联合血清CEA可有效提高结直肠癌的检出率和诊断准确性,且具有无创、方便、诊断效能高等优点,临床上值得推广。

Objective To explore value of the noninvasive feces SDC2 methylation combined with serum CEA in early diagnosis of colorectal cancer.Method 64 cases of patients with colon cancer patients,58 cases of colorectal tumor and 60 cases of healthy control people in our hospital were selected as the research object.Fecal DNA was extracted,and methylation specific PCR method was used for determination of three groups of patients SDC2 excrement gene methylation.Meanwhile,venous blood was extracted and chemiluminescence immunoassay was employed to detect the serum CEA levels.The diagnosis values of SDC2 methylation combined with serum CEA performance for the colorectal cancer were compared.Results The positive rate of SDC2 methylation detection in the colorectal cancer,colorectal tumor group and healthy control group were 67.19%,55.19%and 11.67%respectively,the positive rates of CEA detection were 39.06%,17.24%and 8.33%,and the positive rates of joint detection were 82.81%,58.62%and 13.33%respectively.The difference all had statistical significance(P<0.05).ROC curve analysis found that the AUC of SDC2 genetic detection in the diagnosis of colorectal cancer was 0.629(95%CI:0.474~0.783),the AUC of serum CEA levels in the diagnosis of colorectal cancer was 0.512(95%CI:0.357~0.632),the AUC of joint detection diagnosis of colorectal cancer AUC was 0.782(95%CI:0.642~0.856).Joint diagnosis of colorectal cancer has the highest AUC value compared with single SDC2 and CEA detection.The difference was statistically significant(P<0.05).Conclusion Noninvasive feces SDC2 gene methylation combined with serum CEA can greatly improve the detection rate and accuracy for screening early colorectal cancer,which was noninvasive,convenient with higher diagnosis efficiency advantages.It was worth promoting clinically.